ANKLE FOOT ORTHOSES FOR MANAGEMENT OF SPASTIC DIPLEGIA

用于治疗痉挛性截瘫的踝足矫形器

• 批准号: 3331475
• 负责人: CHRISTOPHER L VAUGHAN
• 金额: $ 13.35万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-09-30 至 1995-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3331475
• 关键词: ankle; assistive device /technology; cerebral palsy; child with disability; computer data analysis; electromyography; foot; gait; human subject; middle childhood (6-11); muscle function; muscle tone; posture; preschool child (1-5)

Children who have cerebral palsy (CP) and spastic diplegia tend to walk with great difficulty and expend considerable energy. An ankle foot orthosis (AFO) is often chosen as the first means of treating these children. However, there are no accepted objective criteria for the prescription of AFOs: their efficacy is controversial, and their cost is not trivial. The long term goal of this research is to improve the mechanics and therefore the gait of children with CP by the application of appropriate AFOs. The apparent benefits of the AFO are: to control undesirable motions, to stabilize weak muscles, and to reduce abnormal muscle tone. We theorize that the AFO controls the ankle joint torques, and these effects propagate up the legs to the proximal joints. We hypothesize that for a child with spastic diplegia the standard and dynamic AFOs, when compared to wearing shoes alone, will: (1) produce a more normal joint torque profile; (2) facilitate more normal muscle activation patterns; and (3) increase efficiency (as measured by V02 consumption). We further hypothesize that the relative efficacy of standard versus dynamic AFOs to enhance locomotion can be tested with the above three dependent measures. Upon completion of this project, the following specific objectives will have been realized: approval or disapproval of the first three hypotheses; establishment of objective criteria to base prescription of standard and dynamic AFOs; validation of gait analysis as a decision-making tool for treating children with CP; and identification of underlying causes of neuromuscular disability, rather than merely documenting effects. We will analyze 36 children under each of three conditions: with shoes alone; with standard AFOs; and with dynamic AFOs. A repeated measures crossover design with an analysis of variance will be used. Computer assessment of both posture and gait will be made. To quantify improvement in function we will measure spatial, kinetic and EMG variables using a 3D dynamic gait analysis system, while V02 will be measured to assess energy efficiency.

患有脑瘫和痉挛性双瘫的儿童倾向于走路 费了很大的劲，费了很大的劲。 踝足 矫形器（AFO）通常被选为治疗这些疾病的首选方法。 孩子 然而，没有公认的客观标准， AFO的处方：它们的功效是有争议的，它们的成本是 不是小事 这项研究的长期目标是提高 力学，因此与CP儿童的步态的应用 合适的AFO。 AFO的明显好处是： 不良运动，以稳定薄弱的肌肉，并减少异常 肌肉张力 我们认为AFO控制踝关节扭矩， 并且这些效应沿着腿向上传播到近端关节。 我们 假设对于患有痉挛性双瘫的儿童， 与只穿鞋子相比，动态AFO将：（1）产生 更正常的关节扭矩曲线;（2）促进更多的正常肌肉 激活模式;以及（3）增加效率（如通过V02测量的 消费）。 我们进一步假设， 标准与动态AFO，以提高运动，可以测试与 以上三项措施相互依存。 项目完成后， 将实现以下具体目标：批准或 不赞成前三个假设;确立目标 标准和动态AFO基础处方的标准; 步态分析作为治疗CP儿童的决策工具; 和神经肌肉残疾的根本原因的识别， 而不仅仅是记录效果。 我们将分析36名儿童 在以下三种情况下：仅穿着鞋子;穿着标准AFO; 动态AFO。 重复测量交叉设计及其分析 将使用方差。 姿势和步态的计算机评估 将被制作。 为了量化功能的改善，我们将测量 使用3D动态步态分析的空间、动力学和EMG变量 系统，而V02将被测量，以评估能源效率。